MHI-815-INFORMATICS FOR ADVANCED PRACTICE
Module 3: Discussion
Assignment Description:

Technical Support to Healthcare: Electronic Health Records and Applications
Choose a specific evidence-based practice (examples: CLABSI prevention, Sepsis risk assessment, Vaccination schedules, etc.).
1. Discuss how technology and informatics are utilized to support the interventions of Advanced Practice Nurses?
2. Discuss how employing evidence-based practice guidelines improve patient outcomes?
3. What benefits and challenges have you experienced with the integration of information technology in your practice?
4. What strategies did you, or could you, use to overcome these challenges?
5. If you could design the “perfect” EHR to enhance and support evidence-based practice, what would you include? How would this new technology improve patient care?
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Leslie Webb

Module 3: Discussion
Choose a specific evidence-based practice (examples: CLABSI prevention, Sepsis risk assessment, Vaccination schedules, etc.).
1. Discuss how technology and informatics are utilized to support the interventions of Advanced Practice Nurses?
Technology and informatics are utilized to support best practice changes. The informatics technology with electronic medical records makes tracking progress and outcomes easier for application to practice changes. The transformation of data collected with research in the patient care setting is analysis. It is crucial to select measurement tools that will provide information for outcome of interest. Informatics allows advanced practice nurses to communicate and treat diseases more effectively. In relation to Chlorhexidine bathing for reduction of hospital acquired infections several pilot studies were conducted and provided to implement intervention or change in practice. A standard bathing protocol with 4% chlorhexidine solution was implemented and produced a 52% reduction in hospital acquired infections (Chapman et al., 2021).
2. Discuss how employing evidence-based practice guidelines improve patient outcomes?
By employing evidence-based practice guidelines patient outcomes can be improved on multiple levels. Often the outcome desired during research leads to secondary unexpected outcomes that can often times be useful for application. Connor et al., (2023) stated from 752 research studies reviewed 89% reported improved patient outcomes with application of evidence-base practice guidelines. A gap that was identified in this study was that nurses did not always implement the EBP guideline across all disciplines. Many organizations provide funding for Quality Improvement (QI) projects and not directly EBP funding. As a result, there are fewer evidence-based practice guidelines put into place. If organizations continue to favor or offer funding for QI advanced practice nurses must be the driving force to ensure any QI implemented is evidence based.
3. What benefits and challenges have you experienced with the integration of information technology in your practice?
In integration of information technology into practice several barriers were faced. The original pilot study for chlorhexidine bathing to reduce hospital acquired infections was implemented on my unit. Several of the nurses did not understand the protocol or need for a change from routine bathing and care. Although data collected supported a reduction in post-operative infections the staff were still reluctant to integrate. The benefits of information technology are assisted with data collection and presentation of graphs/charts for frontline staff to see clearly. The data analyzed from the pilot study showed a reduction in CAUDI, CLABSI, and hospital acquired infections with external devices such as temporary pacemakers and chest tubes. The technology allowed for presentation of improved patient outcome and assisted with clinical decision support.
4. What strategies did you, or could you, use to overcome these challenges?
I utilized various strategies to overcome these challenges in the pilot study for chlorhexidine solution bathing. The first was providing evidence gathered at other institutions and studies to confirm this change could improve outcomes. I utilized my nursing students to assist with the implementation on the clinical unit. They were excited to be able to participate in research. This assisted with the application of new practice guidelines which became contagious to the senior more resistant staff on the unit. As data was collected it was quicky analyzed to validate the desired outcomes. Education was provided frequently for frontline staff and feedback was collected. The project outcomes were shared with faculty and the results assisted with confirmation to make a practice change to improve post-surgical patients outcomes.
5. If you could design the “perfect” EHR to enhance and support evidence-based practice, what would you include? How would this new technology improve patient care?
The perfect EHR would be a challenge to develop as I have little informatics technology background. However, I would love all files to be provided in tabs easily located to trend medical history and conditions. I would also like the addition of teaching implemented tabs and evaluation of topics taught to be easily accessible. Patient teaching is a very simple low cost evidence based practice intervention, but at the organization I work with it is not week documented (Sallam et al., 2021). I would like a better way to track this education and what was provided each interaction to patients and families. I know the saying I remember from Nursing school is if you do not chart it you did not do it 🙂 So is teaching being conducted to improve management of post-operative outcomes or not. Some see the paperwork as a tasks and false document it was completed without actually teaching. This may be prevented if the EHR had a section for teaching and the patients response with a time stamp for accuracy.
References
Chapman, L., Hargett, L., Anderson, T., Galluzzo, J., & Zimand, P. (2021). Chlorhexidine Gluconate Bathing Program to Reduce Health Care–Associated Infections in Both Critically Ill and Non–Critically Ill Patients. Critical Care Nurse, 41(5), e1–e8. https://doi-org/10.4037/ccn2021340Links to an external site.
Connor, L., Dean, J., McNett, M., Tydings, D. M., Shrout, A., Gorsuch, P. F., Hole, A., Moore, L., Brown, R., Melnyk, B. M., & Gallagher, F. L. (2023). Evidence‐based practice improves patient outcomes and healthcare system return on investment: Findings from a scoping review. Worldviews on Evidence-Based Nursing, 20(1), 6–15. https://doi-org/10.1111/wvn.12621Links to an external site.
Sallam, G. K. S., Abdalla, K. F., & Mahmoud, S. F. (2021). Effect of an educational program for patients post coronary artery bypass surgery on the compliance with symptoms management strategies. Indian Journal of Forensic Medicine & Toxicology, 15(4), 1194–1203. https://doi-org/10.37506/ijfmt.v15i4.16872Links to an external site.

Audrey Johnson-Dale
Week 3 Discussion – Initial Post
In Family Medicine at my organization, we follow the evidence-based guidelines of the U.S. Preventive Services Task Force. A specific EBP prevention practice that is a staple in Family Medicine practice is screening for depression and suicide risk in children and adolescents. The USPSTF recommends that minors, aged, 12-18, be screened for major depressive disorder (U.S. Preventive Services Task Force, 2022). The Advanced Practice Nurse utilizes various forms of depressions screenings to identify patients who have previously not been diagnosed with a mental health condition or are not exhibiting signs of depression or possible self-harm at that exact moment in time to screen for these potential behaviors. The Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders defines signs of depression as having at least two weeks of mild ranging to severe sadness, lack of interest, irritability, fatigue, poor concentration, difficultly sleeping, decreased energy, and appetite changes (American Psychiatric Association, 2013). The DSM5 lists signs of suicide as any type of suicidal behavior or ideation, any behavior that is intended to cause self-injury, any suicide attempts (non-fatal/non-completion), or suicide completion (American Psychiatric Association, 2013).
1. Discuss how technology and informatics are utilized to support the interventions of Advanced Practice Nurses?
Healthcare apps have deployed Psychiatric Services. There is a slew of apps dedicated to helping depression, bipolar, schizophrenia, and anxiety-ridden patients (Ng, Firth, Minen, & Torous, 2019), but there has been a slow increase to service engagement. Electronic Health Record Data merging with clinical decision support systems (CDSS) have created the capability to identify which patients have and have not been screened within a 12-month rolling calendar year for depression and suicide risk (Sutton, et al., 2020). Telehealth services for psychiatry care are now available as well, with or without referrals (Gordon, Landman, Zhang, & Bates, 2020). These virtual and web-based systems can be merged into the patient’s electronic medical record as well.
2. Discuss how employing evidence-based practice guidelines improve patient outcomes?
Children and adolescents are exposed to psychological factors as well as genetic factors, which make them a higher risk for depression and suicide (U.S. Preventive Services Task Force, 2022). These psychological factors can be abuse, bullying, environmental, gender identity, traumatic exposure, neglect, insecure parental relationship, etc. Race and socioeconomical status also play a significant part in predisposition to depression and suicide as Black children have reported a higher rate of suicide attempts in the past few years (U.S. Preventive Services Task Force, 2022). Family Medicine is about taking care of the family unit, and to protect the lives of the children –

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How technology and informatics are utilized to support the interventions of Advanced Practice Nurses

Technology and informatics are utilized to support the interventions of Advanced Practice Nurses (APNs) in a number of ways. For example, EHRs can be used to track patient progress, identify patients who are at risk for certain conditions, and provide evidence-based recommendations for treatment. Additionally, telehealth can be used to provide care to patients who live in rural areas or who have difficulty accessing traditional healthcare services.

How employing evidence-based practice guidelines improve patient outcomes

Employing evidence-based practice guidelines can improve patient outcomes by ensuring that patients receive the most effective treatments available. Guidelines are based on the best available research, and they can help APNs to make informed decisions about treatment. Additionally, guidelines can help to ensure that patients receive consistent care, regardless of who is providing their care.

What benefits and challenges have you experienced with the integration of information technology in your practice?

I have experienced a number of benefits and challenges with the integration of information technology in my practice. Some of the benefits include:

Improved communication with patients and other healthcare providers
Increased access to information and resources
Improved efficiency and productivity
Reduced costs
Some of the challenges I have experienced include:

Learning curve for new technology
Technical problems
Data security concerns
Lack of interoperability between different systems
What strategies did you, or could you, use to overcome these challenges?

To overcome the challenges I have experienced with the integration of information technology in my practice, I have used a number of strategies, including:

Training on new technology
Working with IT staff to troubleshoot technical problems
Implementing data security measures
Choosing systems that are interoperable with other systems
If you could design the “perfect” EHR to enhance and support evidence-based practice, what would you include? How would this new technology improve patient care?

If I could design the “perfect” EHR to enhance and support evidence-based practice, I would include the following features:

A user-friendly interface that is easy to navigate
The ability to easily access patient data and records
The ability to generate reports and graphs to track patient progress
The ability to provide evidence-based recommendations for treatment
The ability to integrate with other healthcare systems
I believe that this new technology would improve patient care by making it easier for APNs to provide high-quality care. By providing easy access to patient data and records, APNs would be able to make more informed decisions about treatment. Additionally, by providing evidence-based recommendations for treatment, APNs would be able to ensure that patients receive the most effective treatments available.

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